REDUCING HIV RISK BEHAVIORS & PSYCHOSOCIAL STRESSORS AMONG BISEXUAL AFR/AMER MEN

减少艾滋病毒风险行为

• 批准号: 7339262
• 负责人: Nina Thawata Harawa
• 金额: $ 34.42万
• 依托单位: CHARLES R. DREW UNIVERSITY OF MED & SCI
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7339262
• 关键词: AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Address; African American; Alcohol consumption; Alcohols; Anus; Anxiety; Asians; Behavior; Bisexual; California; Case Study; Centers for Disease Control and Prevention (U.S.); Coitus; Communities; Condition; Conflict (Psychology); Data; Diagnosis; Effectiveness of Interventions; Epidemic; Female; Funding; Gays; Gender; Gender Role; HIV; HIV Infections; Heterosexuals; Hispanics; Hour; Human immunodeficiency virus test; Infection; Intervention; Latino; Lead; Literature; Los Angeles; Measures; Mediating; Mediator of activation protein; Mental Depression; Meta-Analysis; Modeling; Modification; Numbers; Outcome; Pacific Island Americans; Participant; Pharmaceutical Preparations; Phase; Prevalence; Process; Psychosocial Assessment and Care; Publishing; Randomized; Randomized Controlled Trials; Regression Analysis; Research; Risk; Risk Behaviors; Risk Reduction; Secrecy; Sex Behavior; Sexual Partners; Standards of Weights and Measures; Stigmata; Surveys; Testing; Thinking; United States National Institutes of Health; Universities; Vagina; Week; Woman; base; design; ethnic minority population; high risk sexual behavior; improved; male; man; men; men who have sex with men; novel; programs; prospective; psychological distress; psychosocial; racial and ethnic disparities; sex; social stigma; stressor; theories; therapy design

HIV directly or indirectly related to men who have sex with men (MSM) is the single largest contributor to HIV/AIDS cases among Blacks. It accounts for nearly half of all cases among Black men and a substantial but unknown number of cases among Black women (CDC 2005). Despite large racial/ethnic disparities in HIV prevalence and risk, just one tested intervention specifically for African American MSM has been published. Because of their lack of identification with gay communities, strong identification with ethnic communities, sexual relationships with both genders, and frequent secrecy issues regarding same-sex behavior, African American men who have sex with both men and women (MSMW) may not respond to interventions targeting gay men. In order to address these racial/ethnic disparities and an important gap in the intervention literature, we propose to test the efficacy of the Men of African American Legacy Empowering Self(MAALES) Project-a newly developed, novel, and culturally congruent intervention designed to reduce sexual risk behaviors and improve psychosocial outcomes in African American MSMW. The MAALES intervention - guided by the Theory of Reasoned Action and Planned Behavior (TRA/TPB), the Critical Thinking and Cultural Affirmation (CTCA) Model, and the Empowerment Theory- was developed through an extensive, formative research process. The small group intervention involves six two-hour sessions lead by ethnically matched facilitators and held over three weeks with booster sessions at 1.5 and 4.5 months post. In our proposed study, a Phase 2a randomized controlled trial, we will test the MAALES intervention with 300 MSMW evenly randomized to intervention and waitlisted (standard treatment) control conditions. Three- and six-month assessments will be conducted after completion of the intervention for all measures with an additional immediate post-assessment for psychosocial measures. The Specific Aims are to: reduce (1a) HIV-related sexual risk behaviors (i.e., episodes of unprotected intercourse and number of partners) and (1b) sex under the influence of drugs or alcohol; and (2) to improve psychosocial outcomes (i.e., reduce HIV stigma and increase racial and cultural pride) among African American MSMW. Exploratory aims examine the influences of theoretical mediators (i.e., reductions in internalized homophobia and gender role conflicts) on the intervention effect and potential moderation by psychological distress. Bivariate and multiple regression analyses will be used to compare outcomes between the two intervention conditions and to examine mediating effects and effect modification. Study findings will be used to develop a NIH R01 application for a larger (Phase 2b) trial, to tailor intervention approaches for African American men who have sex with both male and female partners, and to guide adaptation for use with other ethnic minority MSMW.

与男男性行为者 (MSM) 直接或间接相关的艾滋病毒是导致艾滋病毒感染的最大单一因素 黑人中的艾滋病毒/艾滋病病例。它占黑人男性所有病例的近一半，并且大量 但黑人女性中的病例数量未知（CDC 2005）。尽管存在巨大的种族/民族差异 HIV 患病率和风险，只有一项专门针对非洲裔美国男男性接触者经过测试的干预措施 发表。由于他们缺乏对同性恋群体的认同，对种族的强烈认同 社区、与两性的性关系以及有关同性的常见保密问题 行为，与男性和女性发生性行为的非裔美国男性 (MSMW) 可能不会做出反应 针对男同性恋者的干预措施。为了解决这些种族/民族差异和重要差距 干预文献中，我们建议测试非裔美国人遗产男性的功效 自我赋权（MAALES）项目——一项新开发的、新颖的、文化上一致的干预措施 旨在减少非裔美国人 MSMW 的性危险行为并改善心理社会结果。 MAALES 干预 - 以理性行动和计划行为理论 (TRA/TPB) 为指导， 发展了批判性思维和文化肯定（CTCA）模型以及赋权理论 通过广泛的、形成性的研究过程。小组干预包括六次，每次两小时 会议由种族匹配的协调员主持，持续三周，并在 1.5 和 1.5 进行加强会议 4.5个月后。在我们提出的 2a 期随机对照试验中，我们将测试 MAALES 300 MSMW 的干预均匀随机分为干预和候补（标准治疗）对照 状况。所有干预措施完成后，将进行三个月和六个月的评估 措施，并立即对社会心理措施进行额外的事后评估。 具体目标是： 减少 (1a) 与艾滋病毒相关的性危险行为（即无保护性行为的发生） 性行为和伴侣数量）以及 (1b) 在药物或酒精影响下发生性行为； (2) 改善 非洲人的心理社会结果（即减少艾滋病毒耻辱并增加种族和文化自豪感） 美国MSMW。探索性目标检查理论中介因素的影响（即减少 内化的同性恋恐惧症和性别角色冲突）对干预效果和潜在调节的影响 心理困扰。双变量和多元回归分析将用于比较结果 两种干预条件之间的关系，并检查中介效应和效应修正。学习 研究结果将用于开发 NIH R01 应用程序以进行更大规模（2b 期）试验，以定制干预措施 为与男性和女性伴侣发生性关系的非裔美国男性提供方法，并指导 适应与其他少数民族 MSMW 一起使用。